Valle Solange Oliveira Rodrigues, Kuschnir Fabio Chigres, Solé Dirceu, Silva Martha Andrade Vilela, Silva Rosanna Iozzi, Da Cunha Antonio Jose Ledo Alves
Department of Clinical Immunology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
J Asthma. 2012 May;49(4):390-4. doi: 10.3109/02770903.2012.669440. Epub 2012 Apr 3.
To assess the reproducibility and validity of the International Study of Asthma and Allergies in Childhood (ISAAC) asthma written questionnaire (IAWQ) for 6- to 7-year-old children administered to their parents/caregivers through a telephone interview.
Our study included 100 children selected from three health units in Rio de Janeiro, Brazil. In total, 50 asthmatic and 50 non-asthmatic children were evaluated; all participants were required to own a household telephone line. Initially, telephone interviews were conducted with the parents/caregivers using the IAWQ. After 2 weeks, parents/caregivers were invited to complete the IAWQ under supervision provided by the researchers. After fifteen days, the telephone interviews were repeated. The reproducibility between the two telephone interviews was assessed using kappa (κ) coefficients; the construct validity was assessed by comparing the answers obtained in the initial telephone interview in both groups according to the clinical diagnosis of asthma performed by a specialist using sensitivity and specificity coefficients.
Overall, data from 75 children (39 asthmatics) were analyzed, as 25 patients were excluded from the study (11 did not answer phone calls and the responding parents/caregivers for 14 patients were not the same in all study phases). Perfect agreement was observed for the indicator "wheezing in the last 12 months" (κ = 1), while substantial agreement was observed for the "wheezing with exercise," "speech limited by wheezing," and "asthma ever" indicators (κ range, 0.7-0.8). The sensitivity and specificity for "wheezing within the last 12 months" were 64.1% (95% confidence interval (CI), 47.2-78.8) and 88.9% (95% CI, 73.9-96.9), respectively. For the "asthma ever" indicator, the sensitivity and specificity were 87.2% (95% CI, 77.6-95.7) and 100% (95% CI, 90.3-1), respectively. Questionnaire specificity was high for all asthma severity indicators.
The IAWQ for children aged 6-7 years adapted for telephone interviews showed good reproducibility and adequate validity with an ability to distinguish between asthmatic and non-asthmatic participants. Thus, this method could be utilized in epidemiological studies on childhood asthma in locations where telephone lines are available.
评估通过电话访谈向6至7岁儿童的父母/照顾者发放的儿童哮喘及过敏国际研究（ISAAC）哮喘书面问卷（IAWQ）的可重复性和有效性。
我们的研究纳入了从巴西里约热内卢的三个卫生单位选取的100名儿童。总共评估了50名哮喘儿童和50名非哮喘儿童；所有参与者均需拥有家庭电话线。最初，使用IAWQ对父母/照顾者进行电话访谈。2周后，邀请父母/照顾者在研究人员的监督下完成IAWQ。15天后，重复进行电话访谈。使用kappa（κ）系数评估两次电话访谈之间的可重复性；通过根据专科医生进行的哮喘临床诊断，比较两组在初次电话访谈中获得的答案，使用敏感性和特异性系数评估结构效度。
总体而言，分析了75名儿童（39名哮喘儿童）的数据，因为有25名患者被排除在研究之外（11名未接听电话，14名患者的受访父母/照顾者在所有研究阶段不一致）。对于“过去12个月内喘息”指标观察到完全一致性（κ = 1），而对于“运动时喘息”、“喘息限制说话”和“曾患哮喘”指标观察到高度一致性（κ范围为0.7 - 0.8）。“过去12个月内喘息”的敏感性和特异性分别为64.1%（95%置信区间（CI），47.2 - 78.8）和88.9%（95% CI，73.9 - 96.9）。对于“曾患哮喘”指标，敏感性和特异性分别为87.2%（95% CI，77.6 - 95.7）和100%（95% CI，90.3 - 1）。所有哮喘严重程度指标的问卷特异性都很高。
适用于电话访谈的6 - 7岁儿童IAWQ显示出良好的可重复性和足够的有效性，能够区分哮喘儿童和非哮喘参与者。因此，这种方法可用于在有电话线的地区进行的儿童哮喘流行病学研究。
